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Trials. 2022 Dec 20;23(1):1033. doi: 10.1186/s13063-022-06948-9. ABSTRACT BACKGROUND: Ocular rosacea is common and is often managed with long-term antibiotic treatment. Doxycycline is the most commonly selected antibiotic for the treatment of rosacea. As there is no established standard of care treatment dose for rosacea, prescribed doses of doxycycline vary widely. The FDA classifies 40 mg daily dose of doxycycline for ocular rosacea as sub-microbial in comparison to an antibiotic dose of 200 mg daily. However, this "sub-microbial" dose has never been evaluated in patients with ocular rosacea, and even the sub-microbial dose has potential to alter systemic mucosa flora. Here, we present a randomized controlled trial using RNA sequencing to fully characterize the impact of sub-microbial antibiotic dosing of doxycycline on antimicrobial resistance and bacterial composition of the ocular and gut flora. METHODS: In a triple-masked parallel randomized control trial, patients with ocular rosacea will be randomized to three arms: a 40-mg dose of doxycycline, a 200-mg antibiotic dose of doxycycline, or placebo. Collected rectal and lower eyelid samples will be compared for frequency of antimicrobial resistance genetic determinants and microbiome diversity. A subjective ocular surface disease index survey and objective tear breakup time measurement will be determined. DISCUSSION: These results will enhance our understanding of the overall systemic impact of long-term systemic sub-microbial antibiotic dosing for the treatment of chronic recurrent ocular inflammatory diseases. TRIAL REGISTRATION: This trial was registered on ClinicalTrials.org (NCT05296837) on March 22, 2022. PMID:36539810 | PMC:PMC9769060 | DOI:10.1186/s13063-022-06948-9 {url} = URL to article

Dermatol Pract Concept. 2022 Oct 1;12(4):e2022201. doi: 10.5826/dpc.1204a201. eCollection 2022 Nov. ABSTRACT INTRODUCTION: Topical ivermectin is an anti-inflammatory and anti-Demodex drug for papulopustular rosacea. Rosacea is a relapsing disease and the time between recurrences should be considered alongside efficacy. OBJECTIVES: The aims of this study were to assess the time of first relapse and relapse rates of Demodex mite infestation and papulopustular rosacea. METHODS: We conducted a prospective study of subjects affected by different degrees of papulopustular rosacea. Patients that achieved a complete response after treatment were monitored every 4 weeks and up to 32 additional weeks. For each patient, we evaluated recording the time to first relapse and relapse rate of Demodex mite infestation and rosacea. RESULTS: The overall success rate on Demodex infestation was 87.5% only 12.5% relapse. Ivermectin leads to complete response in 70% of patients. Median time to relapse was 140 days, the mean time was 152 days. The global success rate was 54.76%. CONCLUSIONS: Topical ivermectin keeps a remission of Demodex infestation and clinical remission for long time. We proposed a twice weekly ivermectin maintenance therapy to reduce recurrences. PMID:36534532 | PMC:PMC9681206 | DOI:10.5826/dpc.1204a201 {url} = URL to article

Dermatol Pract Concept. 2022 Oct 1;12(4):e2022187. doi: 10.5826/dpc.1204a187. eCollection 2022 Nov. NO ABSTRACT PMID:36534579 | PMC:PMC9681237 | DOI:10.5826/dpc.1204a187 {url} = URL to article

F1000Res. 2021 Nov 17;10:1165. doi: 10.12688/f1000research.73719.1. eCollection 2021. NO ABSTRACT PMID:36519179 | PMC:PMC9716113 | DOI:10.12688/f1000research.73719.1 {url} = URL to article

J Dermatol Sci. 2022 Nov 30:S0923-1811(22)00264-X. doi: 10.1016/j.jdermsci.2022.11.004. Online ahead of print. NO ABSTRACT PMID:36517318 | DOI:10.1016/j.jdermsci.2022.11.004 {url} = URL to article

Drug Des Devel Ther. 2022 Dec 2;16:4127-4138. doi: 10.2147/DDDT.S393122. eCollection 2022. NO ABSTRACT PMID:36483458 | PMC:PMC9724583 | DOI:10.2147/DDDT.S393122 {url} = URL to article

Cureus. 2022 Nov 6;14(11):e31151. doi: 10.7759/cureus.31151. eCollection 2022 Nov. NO ABSTRACT PMID:36483886 | PMC:PMC9724193 | DOI:10.7759/cureus.31151 {url} = URL to article

Dermatology. 2022 Dec 7:1-6. doi: 10.1159/000526602. Online ahead of print. NO ABSTRACT PMID:36476839 | DOI:10.1159/000526602 {url} = URL to article

Ann Dermatol. 2022 Dec;34(6):451-460. doi: 10.5021/ad.22.093. NO ABSTRACT PMID:36478427 | DOI:10.5021/ad.22.093 {url} = URL to article

Biomed Pharmacother. 2023 Jan;157:114091. doi: 10.1016/j.biopha.2022.114091. Epub 2022 Dec 5. NO ABSTRACT PMID:36481403 | DOI:10.1016/j.biopha.2022.114091 {url} = URL to article

Clin Cosmet Investig Dermatol. 2022 Nov 23;15:2519-2521. doi: 10.2147/CCID.S392280. eCollection 2022. NO ABSTRACT PMID:36452437 | PMC:PMC9701777 | DOI:10.2147/CCID.S392280 {url} = URL to article

Skin Res Technol. 2022 Nov 25. doi: 10.1111/srt.13241. Online ahead of print. NO ABSTRACT PMID:36426837 | DOI:10.1111/srt.13241 {url} = URL to article

Ann Dermatol Venereol. 2022 Nov 22:S0151-9638(22)00093-X. doi: 10.1016/j.annder.2022.09.007. Online ahead of print. NO ABSTRACT PMID:36428121 | DOI:10.1016/j.annder.2022.09.007 {url} = URL to article

Plast Reconstr Surg Glob Open. 2022 Nov 18;10(11):e4655. doi: 10.1097/GOX.0000000000004655. eCollection 2022 Nov. NO ABSTRACT PMID:36415622 | PMC:PMC9674483 | DOI:10.1097/GOX.0000000000004655 {url} = URL to article

Asia Pac J Ophthalmol (Phila). 2022 Nov 1;11(6):505-513. doi: 10.1097/APO.0000000000000571. NO ABSTRACT PMID:36417674 | DOI:10.1097/APO.0000000000000571 {url} = URL to article

Dermatol Ther (Heidelb). 2022 Nov 22. doi: 10.1007/s13555-022-00848-1. Online ahead of print. NO ABSTRACT PMID:36414845 | DOI:10.1007/s13555-022-00848-1 {url} = URL to article

J Cosmet Dermatol. 2022 Nov 21. doi: 10.1111/jocd.15519. Online ahead of print. NO ABSTRACT PMID:36409588 | DOI:10.1111/jocd.15519 {url} = URL to article

Skin Appendage Disord. 2022 Nov;8(6):462-468. doi: 10.1159/000525024. Epub 2022 Jun 7. ABSTRACT INTRODUCTION: The present study aimed to obtain fundamental data, including climate conditions and Demodex mites, on rosacea and similar diseases in the situation where the wearing of face masks is mandatory due to the coronavirus disease 2019 pandemic. METHODS: We enrolled 86 Japanese patients habitually wearing face masks with rosacea and similar diseases. Disease severity was assessed using the Investigator Global Assessment. The presence of Demodex mites was examined microscopically. Treatment involved acaricidal and antibiotic agents. RESULTS: The numbers of male and female patients enrolled were 11 and 75, respectively. Among these patients, 85 (98.8%), 57 (66.3%), and 76 (88.4%) had rosacea, rosacea-like dermatitis (RLD), and demodicosis, respectively. The monthly number of patients with rosacea and demodicosis showed two peaks from May to June and in October, during which monthly mean temperature was approximately 20°C (68°F). Improvement rates in rosacea, RLD, and demodicosis were significantly higher when Demodex mites were no longer detected after treatment. CONCLUSION: The present results suggest that a season with a mean temperature of approximately 20°C is a risk factor for rosacea and similar diseases in individuals wearing face masks in Japan, and a decrease in Demodex mites is associated with the attenuation of symptoms. PMID:36407649 | PMC:PMC9672874 | DOI:10.1159/000525024 {url} = URL to article

J Cosmet Laser Ther. 2022 Nov 17:1-6. doi: 10.1080/14764172.2022.2147953. Online ahead of print. ABSTRACT A chemical peel is chemexfoliation, a process of application of a chemical substance to the skin that causes controlled chemical destruction of the epidermis with or without part of the dermis leading to skin regeneration and remodeling. It can be classified depending upon the depth of penetration into superficial, medium, and deep peels. Among various indications, peels can be used to enhance treatment within a variety of conditions including skin- rejuvenation, inflammatory disorders like acne, rosacea, acne scar, and pigmentary disorders like melasma, freckles, lentigens, dyschromia, and post-inflammatory pigmentation. We did a chemical peel for six patients with facial melanosis, diagnosed with Riehl melanosis. All patients had visible clinical improvement. Detailed history and informed consent were taken both for photographs and procedures from all patients. PMID:36384385 | DOI:10.1080/14764172.2022.2147953 {url} = URL to article

JAMA Dermatol. 2023 Jan 1;159(1):95. doi: 10.1001/jamadermatol.2022.4503. NO ABSTRACT PMID:36383347 | DOI:10.1001/jamadermatol.2022.4503 {url} = URL to article

J Clin Aesthet Dermatol. 2022 Nov;15(11):69-74. ABSTRACT OBJECTIVE: Subantibiotic dose doxycycline (SDD40), formulated as a modified-release 40mg capsule administered once daily, is used to treat inflammatory lesions of rosacea. In order to investigate whether the patient's weight or lesion severity impacts clinical outcomes with using SDD40, the efficacy and safety of SDD40 in treating rosacea were evaluated in randomized controlled studies (RCTs). METHODS: Phase II, III, and IV RCTs, and a subsequent meta-analysis were described. For all studies, the primary efficacy endpoint was the change in total inflammatory lesion count (papules, pustules, and nodules) from baseline to Week 16. For one of the studies, body weights were categorized by BMI (body mass index). Secondary efficacy endpoints included the change in Investigator's Global Assessment (IGA). Safety was assessed by monitoring adverse events (AEs). RESULTS: The efficacy of SDD40 was consistent across the studies (two trials including n=72 and n=91 subjects) and meta-analysis (n=127 and n=142). SDD40 remained effective regardless of baseline disease severity and weight (with a weak correlation coefficient below 0.75); overweight or obese subjects with severe rosacea cleared at least as well if not better than those with a normal BMI and mild disease. The treatment was well tolerated with no to minimal gastrointestinal-related AEs. LIMITATIONS: Retrospective analyses have methodological limitations. CONCLUSION: Consistency between study results including the meta-analysis supports the effectiveness and safety of SDD40, irrespective of the weight of the patient or rosacea severity based on inflammatory lesion count at baseline. PMID:36381182 | PMC:PMC9651154 {url} = URL to article

Transl Vis Sci Technol. 2022 Nov 1;11(11):13. doi: 10.1167/tvst.11.11.13. ABSTRACT PURPOSE: Dry eye disease (DED) is a heterogeneous condition with poorly characterized subtypes. The DREAM study was a large multicenter randomized clinical trial that did not find omega-3 to be more effective than placebo in treating symptomatic DED. We performed secondary analysis of DREAM data to characterize DED subtypes and their omega-3 response. METHODS: A total of 535 patients with moderate-to-severe DED were randomized to omega-3 or placebo treatment for one year. We used latent profile analysis to identify subtypes based on baseline Ocular Surface Disease Index, tear break-up time (TBUT), anesthetized Schirmer's test, corneal and conjunctival staining, and meibomian gland dysfunction (MGD). We evaluated omega-3's effect for each subtype using generalized linear regression. RESULTS: Five clinically meaningful DED subtypes were identified. They differed significantly in sex (P < 0.001) and race (P = 0.02). Subtype 1 had the most severe DED signs yet milder symptoms and was associated with more Sjögren's syndrome (21%, P < 0.001). Subtype 2 had the mildest DED signs except MGD. Subtype 3 had the most severe symptoms, out of proportion to DED signs. Subtype 4 had relatively milder symptoms and MGD. Subtype 5 had severe MGD and TBUT and was associated with rosacea (29%, P = 0.04). Omega-3 was not significantly more beneficial than placebo for any subtype. CONCLUSIONS: Five clinically meaningful DED subtypes differed significantly in demographics, symptoms, signs, and systemic disease associations. Omega-3 was not significantly more effective than placebo for any subtype. TRANSLATIONAL RELEVANCE: T3 translational research identifying subtypes in the DREAM study can improve DED clinical classification and targeted management. PMID:36383391 | DOI:10.1167/tvst.11.11.13 {url} = URL to article

J Cosmet Dermatol. 2022 Nov 14. doi: 10.1111/jocd.15492. Online ahead of print. ABSTRACT BACKGROUND: Rosacea may contribute to the development of cardiovascular (CV) diseases by causing endothelial dysfunction (ED), which is known to be the initial step of atherosclerosis, due to its inflammatory features. OBJECTIVE: This study aimed to assess ED in rosacea patients using the flow-mediated dilatation (=dilation) (FMD) method. METHODS: Seventy-three rosacea patients and 73 age, gender-matched healthy volunteers were enrolled. Individuals with cardiac risk factors, pregnant, and lactating women were excluded. Demographic, clinical data and anthropometric measurements were recorded. FMD measurement was performed ultrasonographically by a cardiologist. Systolic and diastolic blood pressures (BP) were measured and hemogram, erythrocyte sedimentation rate (ESR), C-Reactive Protein (CRP), total cholesterol, triglyceride, low-density lipoprotein (LDL), high-density lipoprotein (HDL), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), mean platelet volume (MPV), and fasting blood glucose values were assessed. RESULTS: The FMD value was statistically lower in rosacea patients compared with healthy controls (p = 0.000). Metabolic syndrome, systolic and diastolic BPs, and plasma NLR were higher in the rosacea group (p = 0.009, p = 0.000, p = 0.000, p = 0.000, respectively). According to the multivariate linear regression analysis, rosacea type significantly predicted FMD. CONCLUSIONS: Rosacea is not only a disease limited to the skin, but it may also have systemic involvement. A significant difference was found between FMD values measured in between the case and control groups, suggesting rosacea may have an atherogenic effect. Possible cardiac risks should be considered in rosacea patients, and further evaluation could be warranted. PMID:36374628 | DOI:10.1111/jocd.15492 {url} = URL to article

J Eur Acad Dermatol Venereol. 2022 Nov 11. doi: 10.1111/jdv.18725. Online ahead of print. ABSTRACT BACKGROUND: Rosacea is a chronic inflammatory skin disease with increased macrophage infiltration. However, the molecular mechanism remains unclear. OBJECTIVES: To determine the significance of macrophage infiltration, and correlation between Guanylate binding protein 5 (GBP5) and polarization of macrophages in rosacea-like inflammation. METHODS: Here we tested hypothesis that Guanylate binding protein 5 (GBP5) aggravate rosacea-like skin inflammation by promoting the polarization of the M1 macrophages through the NF-κB signaling pathway. We depleted macrophage by injecting clodronate-containing liposomes. We next explored the association between GBP5 and macrophage in rosacea tissue through transcriptome analysis and immunofluorescence analysis. We evaluated the severity of rosacea-like skin inflammation when BALB/c mice was injected GBP5 siRNA intradermally daily for three consecutive days. At last, to study the causality of knocking down GBP5-blunted M1 macrophages polarization, THP-1 cell was treated with GBP5 siRNA. RESULTS: Macrophage depletion ameliorated rosacea-like skin inflammation in mice, implying the important role of macrophages in the rosacea. Basing on transcriptome analysis, Guanylate binding protein 5 (GBP5) was identified as hub genes that was associated with the macrophage infiltration in rosacea. Next, we found that GBP5 expression was significantly upregulated in rosacea tissues and positively correlated with the macrophage infiltration, the immunofluorescence analysis revealed the colocalization between GBP5 and macrophages. In vivo, silencing of GBP5 attenuated rosacea-like skin inflammation in the LL-37-induced mouse model and suppressed the expression of M1 signature genes such as IL-6, iNOS, and TNF-a. In vitro, knocking down GBP5 significantly blunted the polarization of the M1 macrophages partly by repressing the activation of the NF-κB signaling pathways. CONCLUSIONS: Together, our study revealed the important role of macrophages in rosacea, and identified GBP5 as a key regulator of rosacea by inducing M1 macrophages polarization via NF-κB signaling pathways. PMID:36367676 | DOI:10.1111/jdv.18725 {url} = URL to article

Pharmaceutics. 2022 Oct 28;14(11):2322. doi: 10.3390/pharmaceutics14112322. ABSTRACT In the present investigation, a nanoemulgel of minocycline was formulated and optimized for an improved drug delivery and longer retention time in the targeted area. Combining eucalyptus oil, Tween 20, and Transcutol HP, different o/w nanoemulsions were formulated by the oil phase titration method and optimized by pseudo-ternary phase diagrams. The morphology, droplet size, viscosity, and refractive index of the thermodynamically stable nanoemulsion were determined. Furthermore, optimized nanoemulsion was suspended in 1.0% w/v of Carbopol 940 gel to formulate the nanoemulgel, and for this, pH, viscosity, and spreadability were determined and texture analysis was performed. To compare the extent of drug penetration between nanoemulsion and nanoemulgel, ex vivo skin permeation studies were conducted with Franz diffusion cell using rat skin as the permeation membrane, and the nanoemulgel exhibited sustained-release behavior. It can be concluded that the suggested minocycline-containing naoemulgel is expected to treat acne rosacea more effectively. PMID:36365140 | DOI:10.3390/pharmaceutics14112322 {url} = URL to article